title: Floating thrombus in the left upper pulmonary vein dissolved by dabigatran.
abstract: Pulmonary vein thrombosis (PVT) is a rare but life-threatening condition. Although warfarin reduces the risk of atrial fibrillation (AF)-related stroke by 64%, the use of this drug has some limitations. Dabigatran is a relatively novel therapeutic option for patients with AF. The mechanism of action of dabigatran is unclear, and its ability to dissolve pulmonary vein thrombi is uncertain. Scans from a 64-slice multidetector CT (64-MDCT) scanner can evaluate coronary artery stenosis and detect left atrial appendage thrombi and pulmonary vein thrombi. A 73-year-old male patient presented with chest pain, and a 64-MDCT scan was performed to assess coronary artery stenosis. The 64-MDCT scan showed no stenosis but it did reveal a thrombus located in the centre of the left upper pulmonary vein. After 3 months of dabigatran therapy, the thrombus disappeared. This is the first case report of dabigatran dissolving a left upper pulmonary vein thrombus, as assessed by a 64-MDCT scan.
authors.affiliation: Nagasakiken Tomie Hospital, Goto, Japan.
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Takeuchi
mesh_terms: D000368:Aged; D000991:Antithrombins / Q000627:therapeutic use; D001562:Benzimidazoles / Q000627:therapeutic use*; D000069604:Dabigatran; D003937:Diagnosis, Differential; D017548:Echocardiography, Transesophageal; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D061330:Multidetector Computed Tomography; D011667:Pulmonary Veins; D020246:Venous Thrombosis / Q000175:diagnosis / Q000188:drug therapy*; D015091:beta-Alanine / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000991:Antithrombins; D001562:Benzimidazoles; D015091:beta-Alanine; D000069604:Dabigatran